Acta Oncologica最新文献

{"title":"Long-term real-world outcomes of first-line immunotherapy in non-small cell lung cancer - a population-based cohort study in Sweden.","authors":"Gunnar Wagenius, Anders Vikström, Anders Berglund, Stina Salomonsson, Goran Bencina, Xiaohan Hu, Diana Chirovsky, Hans Brunnström","doi":"10.2340/1651-226X.2025.42746","DOIUrl":"10.2340/1651-226X.2025.42746","url":null,"abstract":"<p><strong>Background: </strong>In a previous study, we explored real-world programmed death-ligand 1 (PD-L1) testing and treatment patterns for patients with advanced non-small cell lung cancer (NSCLC) in the era of immune-oncology. The present study aimed to investigate overall survival (OS) with PD-(L)1 inhibitors with longer-term follow-up in the Swedish setting.</p><p><strong>Materials and methods: </strong>Data were extracted from the Swedish National Lung Cancer Registry for patients with NSCLC stage IIIB-IV and ECOG performance status (PS) 0-2 who initiated first-line systemic treatment from 1-April-2017 to 30-June-2021 with data cut-off 30-June-2022. OS and Kaplan-Meier estimates were calculated from start of the PD-(L)1 inhibitor therapy, with subgroups based on nonsquamous/squamous (NSQ/SQ) histology, and further by PS, and PD-L1 status (available from 1-January-2018) provided sufficient sample size.</p><p><strong>Results: </strong>We identified 784 (NSQ:590/SQ:194) patients treated with first-line PD-(L)1 inhibitor monotherapy and 369 (NSQ:305/SQ:64) patients receiving combination regimens. Median OS (95% confidence interval [CI]) was 15.2 (12.4-17.7) and 12.9 (10.6-15.8) months with monotherapy and 17.0 (13.6-23.9) and 18.0 (13.9-NA) months with combination regimens for NSQ/SQ patients. In PS2, median OS with monotherapy was 5.0 (3.7-7.1) and 8.9 (6.2-12.9) months for NSQ/SQ patients (n = 138/59), 5.3 (3.6-13.4) months with combination regimens in NSQ (n = 58) and not evaluable in SQ patients. For PS0-1 patients with tumor cell PD-L1 expression ≥50%, the median OS for NSQ was 23.8 (17.7-29.3) and 27.3 (21.6-NA) months for monotherapy/combination therapy (n = 281/55), while the median OS for combination regimens for PD-L1 <1% and 1-49% was 18.6 (12.1-26.9) and 15.9 (10.8-26.7) months (NSQ; n = 65/87).</p><p><strong>Interpretation: </strong>Real-world OS in Swedish patients receiving first-line PD-(L)1 inhibitor-based regimens was consistent with that observed in clinical trials. Moderate OS rates were observed in PS2, with limited sample sizes. Further research is needed in these patients, as well as in high PD-L1, given the slightly longer OS for combination therapy compared to monotherapy seen for NSQ.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"415-422"},"PeriodicalIF":2.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-dimensional interpretable deep learning-radiomics based on intra-tumoral and spatial habitat for preoperative prediction of thymic epithelial tumours risk categorisation.","authors":"Yuhua Yang, Jia Cheng, Can Cui, Huijie Huang, Meiling Cheng, Jiayi Wang, Minjing Zuo","doi":"10.2340/1651-226X.2025.42982","DOIUrl":"10.2340/1651-226X.2025.42982","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study aims to develop and compare combined models based on enhanced CT-based radiomics, multi-dimensional deep learning, clinical-conventional imaging and spatial habitat analysis to achieve accurate prediction of thymoma risk classification.</p><p><strong>Materials and methods: </strong>205 consecutive patients with thymoma confirmed by surgical pathology were recruited from three medical centers. Venous phase enhanced CT images were used to delineate the tumor, and radiomics, 2D and 3D deep learning models based on the whole tumor were established and feature extraction was performed. The tumors were divided into different sub-regions by K-means clustering method and the corresponding features were obtained. The clinical-conventional imaging data of the patients were collected and evaluated, and the univariate and multivariate analysis were used for screening. The above types of features were fused with each other to construct a variety of combined models. Quantitative indicators such as area under the receiver operating characteristic (ROC) curve (AUC) were calculated to evaluate the performance of the model.</p><p><strong>Results: </strong>The AUC of RDLCSM developed based on LightGBM classifier was 0.953 in the training cohort, 0.930 in the internal validation cohort, 0.924 and 0.903 in the two external validation cohorts, respectively. RDLCSM performs better than RDLM (AUC range: 0.831-0.890) and 2DLCSM (AUC range: 0.785-0.916) based on KNN. In addition, RDLCSM had the highest accuracy (0.818-0.882) and specificity (0.926-1.000).</p><p><strong>Interpretation: </strong>The RDLCSM, which combines whole-tumor radiomics, 2D and 3D deep learning, clinical-visual radiology, and subregional omics, can be used as a non-invasive tool to predict thymoma risk classification.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"391-405"},"PeriodicalIF":2.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiotherapy quality assurance in the PROTECT trial - a European randomised phase III-trial comparing proton and photon therapy in the treatment of patients with oesophageal cancer.","authors":"Camilla Skinnerup Byskov, Hanna R Mortensen, Marie-Claude Biston, Sara Broggi, Rebecca Bütof, Richard Canters, Gilles Crehange, Gilles Defraene, Jerome Doyen, Mai L Ehmsen, Silvia Fabiano, Francesco Fracchiola, Farid Goudjil, Karin Haustermans, Sarah E Jensen, Maria F Jensen, Marie Lecornu, Sebastian Makocki, Aurélia L Mana, Andrea Martignano, Arturs Meijers, Alfredo Mirandola, Diana A Mitrea, Christina T Muijs, Ditte S Møller, Marianne Nordsmark, Ester Orlandi, Panagiotis Balermpas, Pieter Populaire, Daniele Scartoni, Jessica Serrand, Muhammad Shamshad, Najla Slim, Valentina Vanoni, Anthony Vela, Marie Vidal, Gloria Vilches-Freixas, Damien Weber, Lone Hoffmann","doi":"10.2340/1651-226X.2025.42774","DOIUrl":"10.2340/1651-226X.2025.42774","url":null,"abstract":"<p><strong>Purpose: </strong>To present results from the trial radiotherapy quality assurance (RTQA) programme of the centres involved in the randomised phase-III PROton versus photon Therapy for esophageal Cancer - a Trimodality strategy (PROTECT)-trial, investigating the clinical effect of proton therapy (PT) vs. photon therapy (XT) for patients with oesophageal cancer.</p><p><strong>Materials and methods: </strong>The pre-trial RTQA programme consists of benchmark target and organ at risk (OAR) delineations as well as treatment planning cases, a facility questionnaire and beam output audits. Continuous on-trial RTQA with individual case review (ICR) of the first two patients and every fifth patient at each participating site is performed. Patient-specific QA is mandatory for all patients. On-site visits are scheduled after the inclusion of the first two patients at two associated PT and XT sites. Workshops are arranged annually for all PROTECT participants.</p><p><strong>Results: </strong>Fifteen PT/XT sites are enrolled in the trial RTQA programme. Of these, eight PT/XT sites have completed the entire pre-trial RTQA programme. Three sites are actively including patients in the trial. On-trial ICR was performed for 22 patients. For the delineation of targets and OARs, six major and 11 minor variations were reported, and for six patients, there were no remarks. One major and four minor variations were reported for the treatment plans. Three site visits and two annual workshops were completed.</p><p><strong>Interpretation: </strong>A comprehensive RTQA programme was implemented for the PROTECT phase III trial. All centres adhered to guidelines for pre-trial QA. For on-trial QA, major variations were primarily seen for target delineations (< 30%), and no treatment plans required re-optimisation.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"406-414"},"PeriodicalIF":2.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11931855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rising incidence trends of synchronous prostate and rectal cancers: a population-based study.","authors":"Elias Edfelt, Mehrnoosh Shahrivar, Karin Holmsten, Cecilia Radkiewicz","doi":"10.2340/1651-226X.2025.42592","DOIUrl":"10.2340/1651-226X.2025.42592","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of comprehensive reports on time trends in synchronous prostate and rectal cancers. To address this, we conducted the largest cohort study to date to assess these trends in a population-based setting.</p><p><strong>Methods: </strong>We included all adult (ages 18-99) men with incident prostate cancer in the Swedish Cancer Register in 1993-2019. Age-standardized incidence rates (ASIRs) of prostate cancer per 100,000 male population per year were calculated and compared to the ASIR of synchronous (± 6 months from rectal cancer diagnosis) prostate cancer. Age-adjusted synchronous-to-general incidence rate ratios (IRRs) were predicted using Poisson regression. As a sensitivity analysis to assess the effect of incidental findings due to the anatomical proximity, we investigated synchronous prostate and non-sigmoid colon cancers.</p><p><strong>Results: </strong>Among 238,252 prostate cancer cases, 594 were synchronous with rectal cancer. The incidence of synchronous prostate cancer increased over the study period, with mean ASIR rising from 418/100,000 (1993-2001) to 788/100,000 (year 2011-2019). The synchronous-to-general IRR increased from 1.92 (95% confidence interval (CI) 1.60-2.31) to 2.61 (95% CI 2.32-2.95) over the same periods. Prostate cancer was also more commonly diagnosed in conjunction with non-sigmoid colon cancer than in the overall male population, but no time trend was observed.</p><p><strong>Interpretation: </strong>The incidence of synchronous prostate and rectal cancers has increased over the past 20 years in Sweden, with no signs of plateauing. Future studies are warranted to explore factors contributing to prostate cancer overdiagnosis and to optimize clinical management strategies for this complex patient group.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"374-379"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual health in female and male cancer survivors - compared with age-matched cancer-free controls in Norway.","authors":"Emilie Åsberg, Guro F Giskeødegård, Jarle Karlsen, Cecile E Kiserud, Guro Aune, Marianne Nilsen, Randi J Reidunsdatter","doi":"10.2340/1651-226X.2025.42451","DOIUrl":"10.2340/1651-226X.2025.42451","url":null,"abstract":"<p><strong>Background and purpose: </strong>Sexual dysfunction is a common late effect of cancer reducing quality of life. This study investigated sexual health in cancer survivors shortly after diagnosis and at long-term follow-up compared to the general population.</p><p><strong>Methods: </strong>A nationwide survey stratified by sex and age was distributed to a representative sample of the Norwegian population. Of the 5,135 respondents (33% response rate), 453 were cancer survivors, and 4,682 were cancer-free controls. Time since cancer diagnosis was divided into two categories: 2 years or less (short-term) and over 2 years (long-term). Sexual health was evaluated using the EORTC questionnaires SHQ-22 and the sexual domains of the QLQ-BR23/QLQ-BR45. Multivariable linear regression analyses compared sexual health between cancer survivors and cancer-free controls, and between short- and long-term cancer survivors.</p><p><strong>Results: </strong>Cancer survivors reported significantly poorer sexual health outcomes than cancer-free controls, except for the importance of maintaining a sexually active life, rated equally important. There were minimal differences in sexual health between short-term and long-term cancer survivors. Interestingly, male cancer survivors appeared to be more affected by sexual health challenges than females, when compared to their cancer-free controls.</p><p><strong>Interpretation: </strong>This study is the first to utilize the EORTC SHQ-22 questionnaire to assess sexual health in cancer survivors and controls. Sexual health was found to be significantly worse in cancer survivors compared to age-matched controls. It is imperative to address this overlooked health issue in the follow-up programs for cancer survivors.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"380-390"},"PeriodicalIF":2.7,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic triple-negative breast cancer - current treatment strategies in the Nordics: a modified Delphi study.","authors":"Antonis Valachis, Peeter Karihtala, Jürgen Geisler, Malgorzata K Tuxen","doi":"10.2340/1651-226X.2025.42733","DOIUrl":"10.2340/1651-226X.2025.42733","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study aimed to assess current treatment strategies for metastatic triple-negative breast cancer (mTNBC) and the perceptions of clinical experts in Sweden, Denmark, Norway, Finland, and Iceland, comparing them to international guidelines to provide insights into how these therapies are implemented and adapted to national Nordic guidelines.</p><p><strong>Methods: </strong>A three-round modified Delphi method was followed with consensus defined as 70% agreement. A steering committee selected 20 experienced oncologists as panellists and developed the questionnaires. Questions included items related to treatment preferences in different treatment lines with different clinical scenarios in mTNBC patients.</p><p><strong>Results: </strong>In the first round, eight out of 33 questions on clinical treatment reached consensus with 14 out of 27 in the second round reaching consensus. In round three, eight out of eight questions reached consensus. The preferred treatment for mTNBC patients with PD-L1 positive was checkpoint inhibitors (CPI) in combination with chemotherapy. For patients with germline BRCA mutation and PD-L1 negative disease, PARP-inhibitors were preferred as 1L and sacituzumab govitecan (SG) in both 2L and later lines. Disagreement was observed for chemotherapy in later lines where evidence is sparse or lacking.</p><p><strong>Interpretation: </strong>The high level of consensus for new treatment strategies, such as CPI and PARP-inhibitors in 1L and SG in 2L or later lines, in comparison with the limited consensus for older treatments, such as chemotherapy, may reflect the growing academic evidence for different treatment strategies. Understanding the treatment patterns across different countries contributes to gaining consensus on the upcoming therapeutic advances.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"349-357"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorectal cancer mortality in persons with severe mental illness: a scoping review with meta-analyses of observational studies.","authors":"Paula R Pop, Gitte S Larsen, Mette K Thomsen, Christoffer Johansen, Robert Zachariae, Bolette Skjødt Rafn","doi":"10.2340/1651-226X.2025.42260","DOIUrl":"10.2340/1651-226X.2025.42260","url":null,"abstract":"<p><strong>Background and purpose: </strong>Persons with severe mental illnesses (SMIs) have reduced participation in colorectal cancer (CRC) screening programs, higher odds of advanced stage at diagnosis, and are less likely to receive adequate treatment than the general population. It remains unclear to what extent these factors impact CRC outcomes for persons with SMI. The aim of this scoping review was to describe and quantify CRC mortality for persons with SMI compared with the general population.</p><p><strong>Patients/materials and methods: </strong>We followed the JBI Manual for Evidence Synthesis and PRISMA guidelines in a systematic search of four databases from inception until April 29th, 2024. We included studies that provided CRC mortality estimates for adults with preexisting clinical diagnosis of SMI. We synthesized the results descriptively and pooled the data to estimate the magnitude of the associations.</p><p><strong>Results: </strong>Twenty-four original studies were identified with a total of 16.4 million persons. Most studies reported increased CRC mortality for persons with SMI compared with persons without SMI. The meta-analysis demonstrated a 25% increased CRC mortality for persons with SMI (e.g. pooled hazard ratio 1.25; 95% confidence interval 1.13 to 1.39; n = 13,178,161).</p><p><strong>Interpretation: </strong>The evidence points consistently to an increased CRC mortality for persons with SMI compared with persons without SMI. Furthermore, this evidence supports the idea that persons with SMI are a heterogenous population, and as such, any future initiatives to improve CRC outcomes for persons with SMI would warrant a tailored approach to potentiate individual resources, to mitigate stigma and structural discrimination.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"358-373"},"PeriodicalIF":2.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of early death after treatment with curative intent for head and neck squamous cell carcinoma: a retrospective population-based study.","authors":"Mahmoud Bazina, Rayan Nikkilä, Aaro Haapaniemi, Leif Bäck, Sami Ventelä, Antti Mäkitie","doi":"10.2340/1651-226X.2025.42202","DOIUrl":"10.2340/1651-226X.2025.42202","url":null,"abstract":"<p><strong>Background and purpose: </strong>Knowledge regarding the risk factors for early death in patients with head and neck squamous cell carcinoma (HNSCC) is scarce. This study aims to evaluate the rate of early death (during or within 6 months of treatment) and its associated risk factors in HNSCC patients treated with curative intent.</p><p><strong>Materials and methods: </strong>A retrospective, population-based analysis of all HNSCC patients (n = 762) treated with curative intent at the Helsinki University Hospital (Helsinki, Finland) during 2012-2015 was conducted. Using the chi-square test, associations between categorical variables were assessed. Univariate and multivariate analyses were performed to identify independent factors for early death.</p><p><strong>Results: </strong>The rate of early death was 10.1% with a median age of 70 years at diagnosis. Advanced stage, smoking > 40 pack-years, and heavy alcohol consumption were associated with increased odds of early death. Elevated thrombocyte levels > 380 (× 10⁹L) were observed more frequently in the early-death group when comparing the levels with the late-death group (p < 0.01). However, only age (odds ratio [OR] 1.05; 95% confidence interval [CI]:1.02-1.08), T4 class (OR 5.98; 95% CI: 2.60-13.74), N2 class (OR 2.98; 95% CI: 2.60-13.74), and N3 class (OR 12.24; 95% CI: 2.99-50.19) emerged as independent risk factors for early death.</p><p><strong>Interpretation: </strong>Early death risk is increased in older patients and those with advanced-stage HNSCC. Elevated thrombocyte count requires further studies to assess its utility as a potential clinical marker.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"339-348"},"PeriodicalIF":2.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescription patterns demonstrate high demand for treating erectile dysfunction following radical prostatectomy.","authors":"Signe Benzon Larsen, Annika Von Heymann, Hein V Stroomberg, Anne Sofie Friberg, Klaus Brasso, Andreas Røder, Susanne Oksbjerg Dalton, Randi Karlsen, Pernille Envold Bidstrup, Annamaria Giraldi, Christoffer Johansen","doi":"10.2340/1651-226X.2025.42262","DOIUrl":"10.2340/1651-226X.2025.42262","url":null,"abstract":"<p><strong>Background and purpose: </strong>Radical prostatectomy can cause erectile dysfunction; however, subsequent treatment with, e.g., phosphodiesterase-5 inhibitors may improve sexual function in the patients. We aim to examine prescriptions for erectile dysfunction after radical prostatectomy and to identify factors that may affect the prescription rate.</p><p><strong>Patients and methods: </strong>A study based on men included in the Danish Prostate Registry (DanProst) in 1995-2021, and information on prescriptions for erectile dysfunction (ATC: G04BE) from the Danish Prescription Registry. We calculated the proportion of prescriptions per month from 1 year before to 2 years after the initial biopsy and odds ratios (ORs) with 95% confidence intervals (CIs) for the risk of having a prescription.</p><p><strong>Results: </strong>We included 9,286 men with radical prostatectomy, 4,221 men managed on active surveillance, and 47,572 men with nonmalignant biopsies for comparison. The proportion of prescriptions increased significantly after biopsy among men with radical prostatectomy compared to men with nonmalignant biopsies and active surveillance. Patients with prior prescriptions for erectile dysfunction had an OR of 3.49 (95% CI, 2.98-4.08) of new prescriptions 6 months after the initial biopsy. Compared to patients treated with bilateral nerve-sparing surgery, patients with unilateral nerve-sparing surgery had an OR of 1.23 (95% CI, 1.06-1.43), whereas patients without nerve-sparing surgery had an OR of 0.40 (95% CI, 0.34-0.46).</p><p><strong>Interpretation: </strong>The observed patterns of prescriptions demonstrate a high demand for the treatment of erectile dysfunction following radical prostatectomy. The group of prostate cancer survivors is large, and, thus, a strong clinical focus on managing erectile dysfunction is needed.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"331-338"},"PeriodicalIF":2.7,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-measured leg circumference for the detection of lymphedema among men with prostate cancer: a reliability study.","authors":"Gitte Sone Larsen, Sandra Jensen, Annika Von Heymann, Bolette Skjødt Rafn","doi":"10.2340/1651-226X.2025.42249","DOIUrl":"10.2340/1651-226X.2025.42249","url":null,"abstract":"<p><strong>Background and purpose: </strong>Early lymphedema detection is crucial to timely treatment, and home-based monitoring holds promise for early detection of leg lymphedema among at-risk cancer survivors. We developed a self-measurement protocol for home-based leg circumference measurements and tested its reliability in men with prostate cancer at risk of lymphedema.</p><p><strong>Patients/material and methods: </strong>This cross-sectional study recruited men with prostate cancer from the Department of Urology, Copenhagen University Hospital, Denmark. Circumference measurements were taken at four points on both legs, from which leg volume was calculated. Intrarater reliability was assessed by comparing self-measurements taken at home and in the hospital. Interrater reliability was evaluated by comparing hospital self-measurements to those of a blinded physiotherapist. Statistical power required 13 participants for the detection of a good (>0.8) intraclass correlation coefficient (ICC).</p><p><strong>Results: </strong>Forty-three men were included (median age 69 [63-76] years). Intrarater reliability (n = 39) was good to excellent for six out of eight measurement points (ICC ≥ 0.79, p < 0.01) and moderate for two (ICC ≥ 0.55, p < 0.01). Intrarater reliability for leg volume was excellent (ICC ≥ 0.96, p < 0.01). Similarly, interrater reliability (n = 23) was excellent for all measurement points and leg volumes (ICC ≥ 0.91, p < 0.01). Forty-one of 43 participants performed the measurements independently, found them easy to do, and were willing to conduct self-measurements if recommended by their doctor.</p><p><strong>Interpretation: </strong>Self-measured leg circumference among men with prostate cancer is highly reliable and acceptable. This low-cost approach for home-based monitoring for lymphedema offers potential for early detection and timely management of the condition.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"326-330"},"PeriodicalIF":2.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}